Nearly 1 in 4 Opioid Addiction Patients Use CBD — Mostly for Anxiety, Pain, and Sleep | Research

The takeaway

Among 550 people in opioid addiction treatment, 23% used CBD — primarily for anxiety, pain, sleep, and depression — with 42% using it specifically to ease opioid withdrawal symptoms.

Read this if you're in recovery from opioid addiction and curious about CBD, or if you treat OUD patients and want to understand how they're already using CBD on their own.

What the researchers found

CBD has become wildly popular, with claims ranging from anxiety relief to pain management. But how are people with serious opioid addictions actually using it? This survey from Mount Sinai's Addiction Institute provides a window into a population where the stakes are high and the potential for both benefit and harm is significant.

Among 550 people receiving treatment for opioid use disorder (OUD), 129 (23%) reported using CBD. Their reasons paint a picture of broad symptom self-management: anxiety (62.8%), pain (50.4%), sleep (48.8%), depression (48.1%), and recreation (24.8%). But two findings stand out for their clinical significance.

First, 42% of CBD users reported using it specifically to ease opioid withdrawal symptoms. Withdrawal is the most immediate barrier to opioid recovery — it's physically miserable and drives relapse. If CBD genuinely helps with withdrawal, it could be a valuable adjunct to medications like buprenorphine and methadone. Early preclinical evidence supports this possibility, but clinical trials are limited.

Second, 17% reported using CBD to control their addiction itself. This is a more ambitious claim, and the evidence is thinner — but the fact that patients in active addiction treatment are independently turning to CBD for this purpose suggests it deserves rigorous investigation.

The study also compared perceptions between CBD users and non-users, finding that users had more positive views of CBD's potential — not surprising, but it confirms that personal experience drives perception in this population, not clinical evidence.

Why it matters

The opioid crisis has killed hundreds of thousands of Americans, and treatment options, while effective, are limited. If CBD can reduce withdrawal severity and support recovery — even modestly — it could save lives. This survey establishes that patients are already using CBD for these purposes, independently and without clinical guidance, making clinical trials to determine efficacy and safety an urgent priority.

The numbers in context

550 survey completers. 129 (23%) reported CBD use. Reasons: anxiety 62.8%, pain 50.4%, sleep 48.8%, depression 48.1%, recreation 24.8%. 42% used CBD for opioid withdrawal. 17% used CBD to control addiction. Survey period: July 2021 – August 2023 at Mount Sinai Addiction Institute.

How the study worked

Cross-sectional survey of individuals receiving treatment for opioid use disorder at the Addiction Institute of Mount Sinai, New York City (July 2021 – August 2023). 587 respondents, 550 completed surveys. Assessed demographics, opioid use, CBD use patterns, and perceptions. Ordinal logistic regression compared perceptions between CBD users and non-users, adjusting for age and race.

Who was studied

N=550 adults in treatment for opioid use disorder, New York City.

What this study cannot tell us

Cross-sectional survey — self-reported CBD use and perceived benefits don't prove CBD actually helped. Patients in addiction treatment may overreport positive experiences with non-opioid substances. No verification of CBD product content or dosing. Selection bias — people willing to complete a survey may differ from those who declined. Single treatment center in New York City. No objective outcomes (urine drug screens, retention in treatment) measured.

How to read the evidence

Cross-sectional survey providing descriptive data on CBD use patterns in an OUD treatment population. Valuable for understanding patient behavior but cannot establish whether CBD actually helps with withdrawal or addiction.

When this study was published

Published in 2024. CBD for opioid use disorder is an active area of clinical trial development.

The bigger picture

This connects to the harm reduction and addiction clusters throughout the database. The neurobiological basis for CBD-opioid interactions is supported by RTHC-00113 (chronic pain and dopamine dysregulation) and RTHC-00091 (CBD enzyme inhibition, which could affect buprenorphine and methadone levels via RTHC-00078). The self-medication pattern mirrors RTHC-00116 (PTSD driving substance use). For harm reduction, the question is whether CBD is a tool or a distraction from evidence-based treatments.

Replication

Not stated in abstract.

Funding

Not reported in abstract.

Conflicts of interest

Not reported in abstract.

Questions still open

Would a randomized trial show CBD reduces opioid withdrawal severity compared to placebo? Is the 42% using CBD for withdrawal finding a genuine therapeutic signal or placebo/expectation effect? Could CBD interact with buprenorphine or methadone through the CYP450 pathways described in RTHC-00091? Should addiction treatment programs proactively counsel patients about CBD — recommending it, cautioning against it, or simply acknowledging its use?

Read the original research

Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder.

Harm reduction journal, 21(1), 135

Harm Reduction Journal is a peer-reviewed journal focusing on evidence-based strategies to reduce the negative consequences of drug use.

View on PubMed ↗Publisher’s paper ↗

Citation

Kudrich, Christopher; Chen, Rebecca; Meng, Yuan; Bachi, Keren; Hurd, Yasmin L. (2024). Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder.. Harm reduction journal, 21(1), 135. https://doi.org/10.1186/s12954-024-01051-5